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Minnesota rates for HCPCS 50576

Renal endoscopy through nephrotomy or pyelotomy, with or without irrigation, instillation, or ureteropyelography, exclusive of radiologic service; with fulguration and/or incision, with or without biopsy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$524.11 / $524.11 / $3,119.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.11 / $563.95 / $815.06
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,118.01 / $15,157.95 / $32,738.65
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$928.34 / $1,436.41 / $2,016.51
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,325.72 / $1,880.04 / $4,522.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,077.48 / $1,812.59 / $2,585.03
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,077.72 / $1,718.81 / $3,561.18
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$948.62 / $1,623.38 / $2,151.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$791.24 / $1,102.36 / $5,920.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$745.72 / $1,459.54 / $2,930.17
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,296.00 / $3,500.00 / $6,361.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$733.15 / $1,343.81 / $2,250.42